My longest shift was while working in a 7 bed ER rural hospital.
It was 1830 and before I could clock in, the doc asked me to help place a chest tube.
I knew it was going to be a bad night.
When I entered the room, there was a 16 year old girl dressed in a bikini resembling the American flag.
She was pale, in obvious respiratory distress while two paramedics were at the bedside giving her oxygen as well as a nurse with a worried look on her face starting two IV lines.
It was noted that her pulse ox was 76% and falling.
I started setting up for the chest tube and the doctor did a needle decompression and inserted the chest tube on her right lung.
Immediately, her pulse ox improved to 100%, and everyone in the room cheered.
This young girl was stabilized and transferred to a trauma center via helicopter in stable condition.
The story was that the rodeo was in town as it is every year.
This young girl was coming into the rodeo to welcome the first day.
Standing on the back of a horse, holding the flag, she lost her footing and fell to the ground, receiving a kick from the horse where she developed a pneumothorax.
I was standing at the nurses station finishing up charting.
Suddenly two guys were walking this young man in his 20’s through the ER door, the patient was full of blood all over and I could see the blood was still pumping out of his carotid artery.
I placed him on the nearest stretcher and he passed out. Pressure was applied to the bleeding artery while oxygen and 2 large bore IV lines were started.
The doctor quickly grabbed the suture kit and applied a couple stitches to the bleeding vessel, surgical was applied.
I already had the rapid infuser going plus two units of O-negative blood.
The patient had a heart rate of 150, BP of 80/40, we gave another 3 units of blood.
Suddenly the young man awakens and starts talking. The family just arrived at the bedside.
The patient says “I was having a nice dream that I was with grandpa fishing. You guys woke me up.”
The parents reported that grandpa has been dead for over 8 years. Now I am starting to believe that there is something more than just a light at the end of the tunnel.
The patient was stabilized and transferred via helicopter to a trauma center.
The story was that this young man was playing pool at the “Wild Turkey Saloon” and kept winning.
One of the cowboys was not happy about that and stabbed him right in the carotid artery with the Q-stick.
We grabbed our sandwiches to eat and take a break while we monitored the outside with a camera directed toward the ER door.
Suddenly, I see an old truck. A man gets out, opens the back tailgate of the truck and takes something out, placing it on the steps and drove away.
I keep eating my sandwich but then I see something crawling around like an animal.
I summoned the doctor and the other nurse so we can go and investigate what is crawling around. We see a 30 year old pregnant female that appeared to be in labor.
She is moaning in pain. We bring her into the ER but noted she has a bunch of cactus needles on her bottom and could not sit down or lay down, so we started to remove her clothing while she screams.
She spoke no English, only Spanish. While she layed on her side, I had some forceps and started pulling cactus needles out, while the other nurse started IV lines and setting up for immediate delivery.
Within 45 minutes we had a 6 lbs. 7 oz. baby girl, healthy, pink and beautiful.
After we gave the patient pain medication, I kept pulling cactus needles from her bottom that seemed to multiply as time went on.
The patient was admitted to the local hospital and 2 days later, she left the hospital but left her baby in the nursery. She disappeared.
The ER doc went through all the loopholes in order to adopt the baby.
This little girl is now 17 and beautiful.
The story was that this patient came from Honduras and had paid a “Coyote” $1,000 to cross her over the USA border.
While the intense walking put her into labor in the desert, she fell on a cactus patch and could no longer walk and the coyote left her.
A Samaritan old rancher saw what was happening, picked her up and brought her to the hospital but wanted no part of this incident.
We were running around cleaning up the ER for the next shift and we were happy because our shift was almost over.
The EMS tone goes out”Major 1050″ and a few minutes later the sheriff goes on the scanner and reports 19 people injured.
0615 next tone goes out any available ems units report to the scene. In the meantime I am getting everyone ready to put the hospital on a “disaster status.”
I called my director of nurses and the administrator to let him know what is going on.
Day shift nurses also started to show up. The sheriff reports there are 4 dead, including the driver.
There are men and women scattered all over the grass, 5 are very critical, and the rest are walking wounded.
The helicopter has been activated at the scene and they can only carry two patients.
The majority of the patients are coming to our little hospital.
Our hospital is now in a disaster mode and we called all staff.
Everyone responded quickly and graciously willing to help.
Thirteen patients started to show up.
We had set up triage outside in the parking lot. Everyone was treated and the critical patients were stabilized and transferred to the nearest trauma center.
The story was that 19 people had paid the “Coyote” $2,000 each to take them away from the border to different locations within Texas.
They had crossed the river during the night and walked miles to meet the driver.
While going at a fast rate of speed, the driver lost control of the vehicle around a bend near our hospital.
Things were finally calming down and I left to get some sleep.
What a night!